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Multidisciplinary dermatology–rheumatology management for patients with moderate-to-severe psoriasis and psoriatic arthritis: a systematic review

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Abstract

The aim of the study was to analyze the efficacy and satisfaction of multidisciplinary dermatology–rheumatology management for patients with moderate-to-severe psoriasis and psoriatic arthritis (PsA). We conducted a systematic literature search in MEDLINE, EMBASE, and Cochrane Library up to September 2015. Selection criteria include (1) adult patients with moderate-to-severe psoriasis and PsA, (2) assessed in a multidisciplinary consultation, (3) comparison with routine separate consultations, and (4) outcome measures to evaluate efficacy and/or satisfaction. Meta-analyses, systematic reviews, clinical trials, cohort studies, and case series were included. The quality of the studies included was graded according to the Oxford Level of Evidence scale. Of 195 articles, three studies complied with the inclusion criteria: two case series and one descriptive study in which 506 patients were evaluated. Patients were referred to the multidisciplinary consultation from dermatology and rheumatology consultations in all but one study, in which primary care was also involved. The reason for the referral was to confirm the diagnosis and/or treatment. Patients were evaluated on a weekly and monthly basis in two and one study, respectively. The evidence obtained is scarce but suggests the efficacy of multidisciplinary consultations in terms of improved skin and joint symptoms after changing treatment (82–56 %), showing higher scores for this type of consultation compared to the usual [4.91 vs. 2.85 (0–5)] and a high level of satisfaction among patients (94 % “very satisfied”). However, waiting times were higher. With the limited evidence found, multidisciplinary management seems to be more effective and more satisfactory for patients with moderate-to-severe psoriasis and PsA than conventional consultations, though this could not be conclusively demonstrated. The results of this review support the benefit of implementing this type of consultation.

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References

  1. Haroon M, Kirby B, FitzGerald O (2013) High prevalence of psoriatic arthritis in patients with severe psoriasis with suboptimal performance of screening questionnaires. Ann Rheum Dis 72:736–740

    Article  PubMed  Google Scholar 

  2. De Marco G, Cattaneo A, Battafarano N, Lubrano E, Carrera CG, Marchesoni A (2012) Not simply a matter of psoriatic arthritis: epidemiology of rheumatic diseases in psoriatic patients. Arch Dermatol Res 304:719–726

    Article  PubMed  Google Scholar 

  3. Mease PJ, Gladman DD, Papp KA, Khraishi MM, Thaçi D, Behrens F et al (2013) Prevalence of rheumatologist-diagnosed psoriatic arthritis in patients with psoriasis in European/North American dermatology clinics. J Am Acad Dermatol 69:729–735

    Article  PubMed  Google Scholar 

  4. Theander E, Husmark T, Alenius GM, Larsson PT, Teleman A, Geijer M et al (2014) Early psoriatic arthritis: short symptom duration, male gender and preserved physical functioning at presentation predict favourable outcome at 5-year follow-up. Results from the Swedish Early Psoriatic Arthritis Register (SwePsA). Ann Rheum Dis 73:407–413

    Article  PubMed  Google Scholar 

  5. Kirkham B, de Vlam K, Li W, Boggs R, Mallbris L, Nab HW et al (2015) Early treatment of psoriatic arthritis is associated with improved patient-reported outcomes: findings from the etanercept PRESTA trial. Clin Exp Rheumatol 33:11–19

    PubMed  Google Scholar 

  6. Richard MA, Barnetche T, Rouzaud M, Sevrain M, Villani AP, Aractingi S et al (2014) Evidence-based recommendations on the role of dermatologists in the diagnosis and management of psoriatic arthritis: systematic review and expert opinion. J Eur Acad Dermatol Venereol 28(Suppl 5):3–12

    Article  PubMed  Google Scholar 

  7. Canete JD, Dauden E, Queiro R, Aguilar MD, Sanchez-Carazo JL, Carrascosa JM et al (2014) Recommendations for the coordinated management of psoriatic arthritis by rheumatologists and dermatologists: a Delphi study. Actas Dermosifiliogr 105:216–232

    Article  CAS  PubMed  Google Scholar 

  8. Villani AP, Rouzaud M, Sevrain M, Barnetche T, Paul C, Richard MA et al (2014) Symptoms dermatologists should look for in daily practice to improve detection of psoriatic arthritis in psoriasis patients: an expert group consensus. J Eur Acad Dermatol Venereol 28:27–32

    Article  PubMed  Google Scholar 

  9. Husni ME, Meyer KH, Cohen DS, Mody E, Qureshi AA (2007) The PASE questionnaire: pilot-testing a psoriatic arthritis screening and evaluation tool. J Am Acad Dermatol 57:581–587

    Article  PubMed  Google Scholar 

  10. Ibrahim GH, Buch MH, Lawson C, Waxman R, Helliwell PS (2009) Evaluation of an existing screening tool for psoriatic arthritis in people with psoriasis and the development of a new instrument: the Psoriasis Epidemiology Screening Tool (PEST) questionnaire. Clin Exp Rheumatol 27:469–474

    CAS  PubMed  Google Scholar 

  11. Gladman DD, Schentag CT, Tom BD, Chandran V, Brockbank J, Rosen C et al (2009) Development and initial validation of a screening questionnaire for psoriatic arthritis: the Toronto Psoriatic Arthritis Screen (TOPAS). Ann Rheum Dis 68:497–501

    Article  CAS  PubMed  Google Scholar 

  12. Peloso PM, Behl M, Hull P, Reeder B (1997) The Psoriasis Arthritis Questionnaire (PAQ) in detection of arthritis among patients with psoriasis. Arthritis Rheum 40(Suppl 9):S64

    Google Scholar 

  13. Tinazzi I, Adami S, Zanolin EM, Caimmi C, Confente S, Girolomoni G et al (2012) The early psoriatic arthritis screening questionnaire: a simple and fast method for the identification of arthritis in patients with psoriasis. Rheumatology 51:2058–2063

    Article  PubMed  Google Scholar 

  14. Luelmo J, Gratacos J, Moreno Martinez-Losa M, Ribera M, Romani J, Calvet J et al (2014) A report of 4 years of experience of a multidisciplinary unit of psoriasis and psoriatic arthritis. Reumatol Clin 10:141–146

    Article  PubMed  Google Scholar 

  15. Cañete JD, Puig L (2014) Multidisciplinary teams for psoriatic arthritis: on aims and approaches. Actas Dermosifiliogr 105:325–327

    Article  PubMed  Google Scholar 

  16. Bañares A, Jover JA, Fernández-Gutiérrez B, Benítez del Castillo JM, García J, Vargas E et al (1997) Patterns of uveitis as a guide in making rheumatologic and immunologic diagnoses. Arthritis Rheum 40:358–370

    Article  PubMed  Google Scholar 

  17. Muñoz-Fernández S, Martín-Mola E (2006) Uveitis. Best Pract Res Clin Rheumatol 20:487–505

    Article  PubMed  Google Scholar 

  18. Phillips B, Ball C, Sackett D, Badenoch D, Straus S, Haynes B et al Oxford Centre for evidence-based medicine levels of evidence. http://www.cebm.net/index.aspx?o=1025. Accessed 16 Jun 2015

  19. Barnes L (2014) Rheumatic skin disorders. Rheumatology (United Kingdom) 53:i13

    Google Scholar 

  20. Wajed J, Gadsby K, Helliwell P, Korendowych E, Oliver S, Parrish L et al (2012) Facilitating a modular approach to the assessment of psoriatic arthritis. Ann Rheum Dis 71(Suppl3):571

    Article  Google Scholar 

  21. De Marco G, Cattaneo A, Carrera C, Tavecchio S, Ricci M, Fracchiolla C et al (2011) Epidemiologic results of early rheumatologic evaluations in a cohort of psoriatic patients complaining of musculo-skeletal symptoms. Arthritis Rheum 63(Suppl 10):S506

    Google Scholar 

  22. Mody E, Husni ME, Schur P, Qureshi AA (2007) Multidisciplinary evaluation of patients with psoriasis presenting with musculoskeletal pain: a dermatology: rheumatology clinic experience. Br J Dermatol 157:1050–1051

    Article  CAS  PubMed  Google Scholar 

  23. Velez NF, Wei-Passanese EX, Husni ME, Mody EA, Qureshi AA (2012) Management of psoriasis and psoriatic arthritis in a combined dermatology and rheumatology clinic. Arch Dermatol Res 304:7–13

    Article  PubMed  Google Scholar 

  24. Pérez-Barrio S, Galindez E, Alzaga JMC, Garcia-Vivar ML, Urigoitia P, Belloso RI (2014) Psoriasis and psoriatic arthropathy multidisciplinary clinic at Basurto University Hospital: 2 years of experience. J Am Acad Dermatol 70(5):AB180

    Google Scholar 

  25. Foulkes A, Chinoy H, Warren RB (2012) High degree of patient satisfaction and exceptional feedback in a specialist combined dermatology and rheumatology clinic. Br J Dermatol 167:38

    Google Scholar 

  26. Wajed J, Helliwell P, Korendowych E, Gadsby K, Oliver S, Parrish L et al (2014) Disease assessment in psoriatic spectrum: a modular approach for use in routine clinical practice. Ann Rheum Dis 73:318–319

    Article  PubMed  Google Scholar 

  27. Wiles KS, Bramham K, Vais A, Harding KR, Chowdhury P, Taylor CJ et al (2015) Pre-pregnancy counselling for women with chronic kidney disease: a retrospective analysis of nine years’ experience. BMC Nephrol 16:28. doi:10.1186/s12882-015-0024-6

    Article  PubMed Central  PubMed  Google Scholar 

  28. Soh MC, Nelson-Piercy C (2015) High-risk pregnancy and the rheumatologist. Rheumatology (Oxford) 54:572–587

    Article  Google Scholar 

Download references

Acknowledgments

We would like to express our very great appreciation to Dr. Silvia Pérez-Barrio for the clarifications made about her study and to David Buss for the English language revision.

Funding

This is a systematic review, as part of the axial spondyloarthritis and psoriatic arthritis guideline (ESPOGUIA) by the Spanish Society of Rheumatology. ESPOGUIA guideline was supported by the Spanish Foundation of Rheumatology (FER) and funded by Abbvie, SA. The FER and Abbvie had no role in the extraction and interpretation of data or in the draft of the manuscript. All authors had full access to all the data included in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

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Authors and Affiliations

  1. Rheumatology Department, Hospital Universitario Infanta Sofía, Paseo de Europa 34, 28702, San Sebastián de Los Reyes, Madrid, Spain

    Tatiana Cobo-Ibáñez & Santiago Muñoz-Fernández

  2. Rheumatology Department, Hospital Universitario de Móstoles, Río Júcar s/n, 28935, Móstoles, Madrid, Spain

    Virginia Villaverde

  3. Research Unit, Spanish Society of Rheumatology, Marqués de Duero 5, 1º, 28001, Madrid, Spain

    Daniel Seoane-Mato, Mercedes Guerra & Petra Díaz del Campo

  4. Rheumatology Department, Hospital Clinic de Barcelona e IDIBAPS, Calle Villarroel 170, 08036, Barcelona, Spain

    Juan D. Cañete

Authors
  1. Tatiana Cobo-Ibáñez
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  2. Virginia Villaverde
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  3. Daniel Seoane-Mato
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  4. Santiago Muñoz-Fernández
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  5. Mercedes Guerra
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  6. Petra Díaz del Campo
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  7. Juan D. Cañete
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Corresponding author

Correspondence to Tatiana Cobo-Ibáñez.

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Conflict of interest

T. Cobo-Ibáñez has received a speaker honorarium from Abbvie and Pfizer. S. Muñoz-Fernández has received research Grants from Pfizer, a speaker and consultancy honorarium from Abbvie, MSD, and Pfizer. JD. Cañete has received consultancy honorarium from Abbvie, Boehringer, Celgene, MSD, Novartis, Novo-Nordisk, Pfizer, and UCB. D. Seoane-Mato, M. Guerra, and P. Díaz del Campo have received sponsorship contract from Abbvie. V. Villaverde declares that she has no conflict of interest.

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Cobo-Ibáñez, T., Villaverde, V., Seoane-Mato, D. et al. Multidisciplinary dermatology–rheumatology management for patients with moderate-to-severe psoriasis and psoriatic arthritis: a systematic review. Rheumatol Int 36, 221–229 (2016). https://doi.org/10.1007/s00296-015-3377-z

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  • DOI: https://doi.org/10.1007/s00296-015-3377-z

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